Objectives This study evaluated whether occupational exposure plays a role for lung cancer at a very young age.

Methods In a pooled analysis of 2 German case-referent studies including 3498 incident cases among men and 3541 male population referents, a group of men (187 cases and 202 referents) aged ;45 years was compared with a group of 2186 cases and 2146 referents aged 55--69 years. Occupational exposure to known (A list) or suspected (B list) lung carcinogens was assessed using job and industry codes, and exposure to asbestos was assessed using job-specific supplementary questionnaires. A conditional logistic regression was used to calculate the odds ratios (OR) and to control for smoking.

Results Asbestos exposure showed an odds ratio (OR) of 2.39 [95% confidence interval (95% CI) 1.41--4.04] for the younger group and 1.46 (95% CI 1.24--1.72) for the older group. Having ever worked in a job belonging to the A list as compared with never working in an A- or B-list job was associated with a significantly increased risk for the younger (OR 2.06, 95% CI 1.03--4.12) and older (OR 1.35, 95% CI 1.10--1.65) groups, adjusted for asbestos. Lung cancer risk for those working in A-list jobs at a very young age (under 16 years) was increased in the younger group (OR 6.14, 95% CI 1.41--28.01) in contrast to the older group (OR 1.19, 95% CI 0.91--1.63).

Conclusion Occupational risk factors play an important role for lung cancer among young men. Early age at first exposure may favor an early age of the onset of lung cancer.

Key terms asbestos exposure; case-referent study; occupation; young adult